Articles: opioid.
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Little is known about relationships between opioid- and gabapentinoid-use patterns and healthcare expenditures that may be affected by pain management and risk of adverse outcomes. This study examined the association between patients' opioid and gabapentinoid prescription filling/refilling trajectories and direct medical expenditures in US Medicare. ⋯ Dose and duration patterns of concurrent OPI-GABA varied substantially among fee-for-service Medicare beneficiaries. Consistent opioid-only users and all concurrent OPI-GABA users were associated with higher healthcare expenditures compared to opioid-only discontinuers.
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Drug Alcohol Depend · Feb 2021
A preliminary examination of the multiple dimensions of opioid craving.
Although craving is a formal DSM-5 criterion and a commonly reported feature of opioid use disorder (OUD), there is no universally accepted assessment of opioid craving for treatment outcome studies or clinical trials. This mixed-methods study characterized dimensions of opioid craving identified in qualitative responses collected via Amazon Mechanical Turk (AMT). ⋯ There is a wide range of dimensions that were used to describe opioid craving and no single unifying dimension was identified. These data suggest opioid craving is a multidimensional construct including dimensions currently not included in common craving assessments.
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J Minim Invasive Gynecol · Feb 2021
Short-acting and Long-acting Opioids Utilization among Women Diagnosed with Endometriosis in the United States: A Population-based Claims Study.
To determine the prevalence and pattern of opioid use in endometriosis and the characteristics of patients prescribed an opioid using medical insurance claims data. ⋯ Although opioids are not a recommended treatment for endometriosis, more than half of our cohort filled an opioid prescription within 1 year after a first recorded diagnosis of endometriosis. Patients who filled an opioid prescription tended to use more endometriosis-related medications and have a higher comorbidity burden. Additional research is necessary to better understand the reasons and outcomes associated with opioid utilization in endometriosis and to determine if there is a more effective pain management treatment plan for patients taking opioids.
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Reg Anesth Pain Med · Feb 2021
Observational StudyInfluence of inpatient opioid consumption on persistent use following total knee arthroplasty.
Total knee arthroplasty (TKA) is associated with a high incidence of continued opioid use beyond the expected period of recovery. The aim of this study was to determine the influence of inpatient opioid consumption on the development of persistent use. ⋯ Larger amounts of opioid consumed in the hospital following uncomplicated, primary TKA may not be associated with an increased risk of persistent use at 6 weeks among opioid-naïve patients. Patients may have unique risk factors for prolonged opioid use that may not necessarily be apparent in the early postoperative period.
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Journal of neurosurgery · Feb 2021
Subcutaneous sumatriptan: association with decreases in postoperative pain and opioid use after elective cranial surgery.
Sumatriptan, a serotonin receptor agonist, has been used in the management of primary headache disorders and has been shown to affect trigeminal dural afferents. There is limited literature on the safety and efficacy of sumatriptan for postcraniotomy pain management. This study aimed to identify whether subcutaneous sumatriptan is a safe and efficacious pain management strategy after elective craniotomy. ⋯ The authors identified subcutaneous sumatriptan as a safe and efficacious tool for postoperative pain management after craniotomy. Large multicenter randomized controlled studies are needed to further evaluate the specific role of sumatriptan in postoperative pain management after craniotomy.